In conversation with Silvie Crawford on her vision for CNO
New ED and CEO prioritizes collaboration and inclusion
CNO’s new Executive Director and CEO Silvie Crawford started her new job on Sept. 7, 2022, and a lot has already happened since then. Crawford has met with Ontario nursing employers and regulators throughout the country, collaborating with the Ontario government on how CNO can play a leadership role to register more nurses to practice safely nursing registration needs and furthering initiatives like modernizing applicant assessment. The Standard got the chance to have an in-depth conversation with Crawford about who she is, how the new role is going and her vision for patient safety.
The Standard: Tell us a bit about yourself. Where are you from, what were you like growing up?
Silvie Crawford, ED and CEO: I was born and raised in Rome, Italy and then my family moved to Toronto. I was into a number of different activities growing up and came home with a few scrapes because I always ventured out and tried new things. I really enjoyed school and had some great teachers. I also used to bring home stray kittens and other animals. My parents were very welcoming. So I'd say I was always aware of my surroundings, and always prioritized caring for others.
The Standard: Sounds like a healthy combination of competitive but caring.
Crawford: I am very grateful for the opportunities that my parents afforded me and to the many wonderful teachers that imparted their knowledge.
The Standard: Some people know from an early age that nursing is their calling. Was there a point when you identified this was the route that you wanted to take? What was the motivation that helped drive that?
Crawford’s favourite things
Favourite Movie: Moonstruck. Cher is amazing.
Favourite artists or bands: I like listening to Adele, and Andrea Bocelli songs are very agreeable. He did a nice collaboration with Ed Sheeran, “Perfect Symphony”.
The last great non-work thing you read: I’m reading the autobiography of artist Emily Carr. I love her art and that of the Group of Seven.
TV or streaming recommendation: All Creatures Great and Small, the new one on PBS. I love that series.
Personal hero: My heroes are everyday heroes. I admire selfless people. I see heroes everywhere... I'm always in awe of people’s capacity to care for others.
Pets: I have a one-year-old dog, a Dalmatian named Bella Luna. She’s a lively and beautiful girl.
Your ideal weekend: I really value the time I spend with family and friends. We try to do family brunches on weekends. I love that downtime and sharing a meal. That’s my ideal weekend.
Crawford: I think it may have started when I was a teenager. My mom was ill and I would go to medical appointments with her because there was a language barrier, and I would translate for her and the health care providers. I think that's when I recognized that I really had a passion for understanding what doctors and nurses did, but also understanding how patients receive care and ensuring that the patient's voice was heard.
The Standard: I can see how fulfilling that would be — to help someone you care about so meaningfully. And you would have a good glimpse of the front lines of health care and what’s needed there, too.
Crawford: At the start of my career, I was a frontline nurse. I thoroughly enjoyed that role. And one day I got called upon by a Vice President who asked why I was not applying for administrative jobs and so we chatted. She seemed to think that I had a nice ability for being able to speak to a broader audience, and could impact and influence practice from an administrative perspective.
That was my “aha!” moment. Instead of going the nurse specialist route, I went the administrative route. And I have loved it ever since. I completed a health law degree after my nursing education because I wanted to be able to understand everything that influenced policy and practice. And that meant regulation and legislation. I really enjoyed it, and that’s when I started taking on different leadership roles, including that of Chief Nurse Executive. I am very grateful for all the coaches and mentors I have had to nurture my career experiences.
So that’s my nursing story. In addition to nursing, social stewardship is also important to me, and I try to support community services through volunteer work. I love governance and supporting organizations with that skill set.
The Standard: You’ve been CNO’s Executive Director and CEO for just over two months. Why did you choose to take on this role and how has it been so far?
Crawford: I'm absolutely thrilled to be here. I’ve met such amazing and dedicated staff and leaders.
I think this is such an important role, and I’m honoured and humbled to serve. It’s always an important time for patient safety, but that feels especially true in this moment. And working at CNO is, to me, a great place for making a difference to public safety and the public interest. It was an incredible opportunity that came my way and I just could not not pursue it.
The Standard: CNO’s patient safety mandate, to protect the public through safe nursing practice, is very important. There’s a lot that goes into that work. Are there particular principles that you look to support this mandate?
Crawford: I think it's always important to be transparent, both with the public as well as nurses. When we're looking at how we do things, it always needs to be with that lens of equity and collaboration. I think those are important starting points.
Looking ahead of us, I really love the principle of co-creating. There are exciting changes that are the result of collaboration with Council and our Ministry partners.
That's why we will focus on ensuring we continue to have strong partnerships with nurses, employers, educators and the public.
There’s more to build on, too. I really value innovation, integrity and respect. These are basic building blocks to achieving a shared purpose. Inclusion and understanding are important elements of partnerships.
The Standard: You mentioned a couple of things there that I want to dive into more detail on. One is the importance of being equitable, and diversity, equity and inclusion (DEI) is a priority for CNO. Can you explain why DEI delivers better patient safety outcomes, in terms of serving all communities and making sure all voices are heard?
Crawford: At CNO, like public-facing and serving organizations around Ontario, we are on a learning journey to figure out how to best embed and support diversity, equity and inclusion principles throughout all we do.
Ontario is as diverse as it is big and nurses in Ontario reflect that diversity – as a health regulator with a public interest focus we have a responsibility to ensure our processes acknowledge and celebrate this diversity while acknowledging the very real lived experiences of equity seeking and equity deserving communities.
Achieving that equity includes engagement with staff, committees and Council. This is a journey that starts with us as an organization, by investing in our people with training, recognizing and celebrating days of cultural significance in Ontario, enhancing our regulatory processes and ensuring our Code of Conduct embraces culturally safe care for all.
And while this journey starts with us as a regulator, it’s an area where we can make a meaningful difference working with others in the health care system and beyond. It’s our responsibility to pay attention to that broad spectrum of the public and be responsive to the needs of everyone. It’s good for patient safety, and it’s the right thing to do.
The Standard: Can you share some of the groups you've met with so far and what you’re hearing from them?
Crawford: Recently we met with our Employer Reference Group, and that was very positive. Recently we also met with nurse regulators across Canada to hear what other provinces are doing, what their challenges are. We are participating in international meetings so we can share and learn from each other.
Prioritizing public safety also means hearing from the public, and we’ve been doing that through our Citizen Advisory Group and through our public consultations.
We are also connecting with our educators, including CNO’s Academic Reference Group, the Council of Ontario University Programs in Nursing, and College of Applied Arts and Technology.
There are also two new and important roles across government that we have made connections to, Ontario’s Chief of Nursing and Professional Practice, as well as the federal Chief Nursing Officer.
We regularly connect with CNO’s Council to understand and ensure that what we're doing is achieving the outcomes they intend us to achieve.
And of course, there’s the expertise of all the CNO staff, who are resolutely committed to our mandate and working collaboratively on solutions. Every day they work towards those efforts, and I feel fortunate to work alongside them.
It’s all these different people and groups working together that can achieve great things, and I can’t wait to build on the foundation we have here.
The Standard: Let’s talk about challenges the health care system is facing now. A topic on everyone’s minds is getting more nurses into the health care system. Can you share some of the work that CNO is doing?
Crawford: CNO has an important role to play here, and that’s registration. A big part of our public protection mandate is registering nurses who have the knowledge, skill and judgment to practice safely in Ontario. So how can we speed that up without compromising patient safety? We’ve done tremendous work already to modernize our own practices and make them more efficient. We’ve collaborated with system partners to create new programs like the Supervised Practice Experience Partnership to help applicants meet requirements.
There’s a lot to build on — we’ve got incredibly rich data and we're working to identify the needs of applicants and communities when it comes to barriers and meeting requirements. A big part of doing this is collaborating with system partners. For example, there's the recently approved regulation changes that will increase the number of nurses who can register in Ontario.
And we’ll be evaluating and assessing our work and initiatives as we go on to ensure we achieve desired outcomes.
The Standard: Do you have a message to share with nurses?
Crawford: I want nurses to know that we understand the difficulties they are in right now, and we’re working to act within our public safety mandate, using feedback from many as well as the data at our disposal, to respond to the health care system and public needs. We have an opportunity to work together to create solutions and make a difference in our efforts to protect the public, and I can’t wait to do more.
